Holistic Care for Reducing Pain Intensity among Individual with Rheumatoid Arthritis: A Systematic Literature Review
DOI:
https://doi.org/10.56359/gj.v7i1.834Keywords:
holistic care, non-pharmacological treatment, rheumatoid arthritisAbstract
Introduction: Rheumatoid arthritis (RA) is a chronic autoimmune disorder marked by persistent joint inflammation that causes pain, stiffness, and impaired mobility. While pharmacological treatment helps manage symptoms, some patients experience side effects or inadequate pain control. Therefore, holistic approaches involving psychological, lifestyle, and physical therapies are increasingly considered to support overall well-being and complement medical management.
Objective: This systematic review aims to assess the effectiveness of holistic interventions in reducing pain intensity among individuals with RA.
Method: A systematic search of six databases PubMed, ProQuest, Garuda, JSTOR, ScienceDirect, and Wiley was conducted for studies published between 2020 and 2024. Eligible studies included RA patients whose pain intensity was measured using validated tools such as the Numerical Rating Scale (NRS), Visual Analog Scale (VAS), or McGill Pain Questionnaire (MPQ). Two independent reviewers performed study selection and data extraction, while quality assessment followed PRISMA guidelines and the CASP Checklist.
Results: Eleven studies comprising 607 participants met the inclusion criteria. The findings showed that holistic interventions including warm ginger compresses, Swedish massage, hand and foot massage, lavender aromatherapy, eucalyptus inhalation, Reiki therapy, and combined ginger compress with rheumatic exercise, were effective in reducing pain intensity in RA patients. Most studies reported significant improvements, with warm ginger compress being the most consistently effective method across various settings.
Conclusion: Holistic approaches demonstrate meaningful benefits in reducing pain and supporting comfort in individuals with RA, particularly among older adults. Consistent application and appropriate duration of therapy enhance effectiveness. Overall, holistic care serves as a valuable complementary strategy that promotes patient-centered pain management and improves quality of life.
Downloads
References
Abdillah, A., Kurnianto, S., & Rizky Wahyuni, M. (2023). The Effectiveness of Massage Therapy on Pain Reduction in Rheumatoid Arthritis Patients: Literature Review. Health and Technology Journal (HTechJ), 1(6). https://doi.org/10.53713/htechj.v1i6.120
Agustina, N., Surahmat, R., Akhriansyah, M., Emiliasari, D., & Saputra, M. A. S. (2023). Kompres Hangat dengan Jahe Sebagai Metode Pengurangan Intensitas Nyeri Pada Lansia dengan Arthritis Rheumatoid. Jurnal Akademika Baiturrahim Jambi, 12(2), 251. https://doi.org/10.36565/jab.v12i2.589
Aisyah, S., Uliyah, M., & Ulfaiza, M. (2023). The Effect of Foot Massage Using Lemongrass Oil on Reducing the Intensity of Rheumatoid Arthritis Pain in the Elderly at the Aisyiyah Clinic, Ambulu Sub-district, Jember Regency. https://doi.org/10.2991/978-94-6463-202-6_18
Akram, M., Daniyal, M., Sultana, S., Owais, A., Akhtar, N., Zahid, R., Said, F., Bouyahya, A., Ponomarev, E., Ali Shariat, M., & Thiruvengadam, M. (2021). Traditional and modern management strategies for rheumatoid arthritis. In Clinica Chimica Acta (Vol. 512). https://doi.org/10.1016/j.cca.2020.11.003
Andreyani, L., & Bhakti, W. K. (2023). Validitas Skala Ukur Nyeri Visual Analog And Numerik Ranting Scales (Vanrs) Terhadap Penilaian Nyeri. Jambura Journal of Health Sciences and Research, 5(2). https://doi.org/10.35971/jjhsr.v5i2.19140
Barão Paixão, V. L., & Freire de Carvalho, J. (2021). Essential oil therapy in rheumatic diseases: A systematic review: Essential oils in rheumatic diseases. In Complementary Therapies in Clinical Practice (Vol. 43). https://doi.org/10.1016/j.ctcp.2021.101391
Erlinawati, N. A., Perceka, A. L., Rusyani, H., Huda, T., & Awaludin, A. A. (2024). The Impact of Ginger Compresses on Alleviating Rheumatic Discomfort Intensity in the Older Individuals at the Social Protection House. International Journal of Integrative Sciences, 3(5), 483–498. https://doi.org/10.55927/ijis.v3i5.9256
Fadrus, S. R., Hamidi, M. N. S., & Syahda, S. (2023). Gambaran Karakteristik Rheumatoid Arthritis pada Lansia di Desa Pulau Birandang Puskesmas Kamp. Evidance Midwifery Journal, 2(3).
Fitriani, V., Nur, A., Cahyanti, L., Yuliana, R., Pujiati, E., Jamaludin, & Pramudaningsih, N. (2024). Peningkatan Kesehatan Pada Lansia Melalui Senam Rematik Untuk Mengatasi Nyeri Penderita Rheumatoid Arthritis. 4(2).
Hamdana, Siringoringo, E., & Eka Rahayu Nensi. (2018). Effect of Ginger Warm Compresses on Pain Intensity Reduction in Patients with Rheumatoid Arthritis. Comprehensive Health Care, 2(2). https://doi.org/10.37362/jch.v2i2.243
Hariati, H., Ismayadi, I., & Nasution, S. S. (2020). Decreasing Of Pain Scale Through Warm Compress Among Elderly With Rheumatoid Arthritis. In Jurnal Penelitian Keperawatan Medik (Vol. 3, Issue 2). http://ejournal.delihusada.ac.id/index.php/JPKM
Hasanah, N. U., Afriyani, R., & Firmansyah, M. R. (2023). Senam Rematik Terhadap Penurunan Skala Nyeri Rhematoid Arthritis Pada Lansia. Jurnal Kesehatan Tambusai, 4(2).
Heriyanto, H., Awanis, H., & Harapan Bengkulu, P. (2023). The Effect Of Foot Massage And Lavender Aromatherapy On Rheumatoid Arthritis Pain Intensity In The Elderly In The Public Health Center Jembatan Kecil Bengkulu City (Vol. 3).
Indarti, E. T., Wilda, L. O., & Wulansari, E. S. (2023). The Effect Of Warm Red Ginger Compresses On Joint Pain In The Elderly With Gout. International Journal Of Nursing And Midwifery Science (IJNMS), 6(3). https://doi.org/10.29082/ijnms/2022/vol6/iss3/424
Koper-Lenkiewicz, O. M., Sutkowska, K., Wawrusiewicz-Kurylonek, N., Kowalewska, E., & Matowicka-Karna, J. (2022). Proinflammatory Cytokines (IL-1,-6,-8,-15,-17,-18,-23, TNF-α) Single Nucleotide Polymorphisms in Rheumatoid Arthritis—A Literature Review. In International Journal of Molecular Sciences (Vol. 23, Issue 4). https://doi.org/10.3390/ijms23042106
Kusuma Wijaya, A. (n.d.-a). The Effect of Warm Red Ginger Compress Therapy on the Decrease in Rheumatoid Arthritis Pain in the Elderly at the Social Institution Tresna Werdha Pagar Dewa Bengkulu. In Indian Journal of Forensic Medicine & Toxicology (Vol. 14, Issue 4).
Kusuma Wijaya, A. (n.d.-b). The Effect of Warm Red Ginger Compress Therapy on the Decrease in Rheumatoid Arthritis Pain in the Elderly at the Social Institution Tresna Werdha Pagar Dewa Bengkulu. In Indian Journal of Forensic Medicine & Toxicology (Vol. 14, Issue 4).
Lu, P. Y., Wu, H. Y., Chen, L. H., Liu, C. Y., & Chiou, A. F. (2023). The Effects of Self-Aromatherapy Massage on Pain and Sleep Quality in Patients with Rheumatoid Arthritis: A Randomized Controlled Trial. Pain Management Nursing, 24(4), e52–e60. https://doi.org/10.1016/j.pmn.2023.02.009
MacIver, A., Hollinger, H., & Carolan, C. (2021). Tele-health interventions to support self-management in adults with rheumatoid arthritis: a systematic review. In Rheumatology International (Vol. 41, Issue 8). https://doi.org/10.1007/s00296-021-04907-2
Majnik, J., Császár-Nagy, N., Böcskei, G., Bender, T., & Nagy, G. (2022). Non-pharmacological treatment in difficult-to-treat rheumatoid arthritis. In Frontiers in Medicine (Vol. 9). Frontiers Media S.A. https://doi.org/10.3389/fmed.2022.991677
Marsiami, A. S. (2023). Manfaat Senam Reumatik Pada Lansia. Indonesian Journal of Health Development, 5(1). https://doi.org/10.52021/ijhd.v5i1.111
Morf, H., da Rocha Castelar-Pinheiro, G., Beatriz Vargas-Santos, A., Baerwald, C., & Seifert, O. (n.d.). Impact of clinical and psychological factors associated with depression in patients with rheumatoid arthritis: comparative study between Germany and Brazil. https://doi.org/10.1007/s10067-020-05470-0/Published
Nissen, R. D., Viftrup, D. T., & Hvidt, N. C. (2021). The Process of Spiritual Care. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.674453
Oktafiani, N., & Kusumawardani, L. H. (2023). Case Study of Effects of Combination Therapy With Acupressure and Warm Compresses (Aku-SeHat) to Reduce Joint Pain in the Elderly. Jurnal Ilmiah Ilmu Keperawatan Indonesia, 13(02). https://doi.org/10.33221/jiiki.v13i02.2261
Petit, C., Culshaw, S., Weiger, R., Huck, O., & Sahrmann, P. (2024). Impact of treatment of rheumatoid arthritis on periodontal disease: A review. In Molecular Oral Microbiology (Vol. 39, Issue 4). https://doi.org/10.1111/omi.12454
Pianarosa, E., Hazlewood, G. S., Thomas, M., Hsiao, R., & Barnabe, C. (2021). Supporting Equity in Rheumatoid Arthritis Outcomes in Canada: Population-specific Factors in Patient-centered Care. Journal of Rheumatology, 48(12). https://doi.org/10.3899/JRHEUM.210016
Putri, R. M., Amir, L., & Alini. (2020). Pengaruh Terapi Back Massage Terhadap Penurunan Nyeri Rheumatoid Arthritis Pada Lansia. Jurnal Ners Universitas Pahlawan, 4(2).
Roodenrijs, N. M. T., Hamar, A., Kedves, M., Nagy, G., Van Laar, J. M., Van Der Heijde, D., & Welsing, P. M. J. (2021). Pharmacological and non-pharmacological therapeutic strategies in difficult-to-treat rheumatoid arthritis: A systematic literature review informing the EULAR recommendations for the management of difficult-to-treat rheumatoid arthritis. RMD Open, 7(1). https://doi.org/10.1136/rmdopen-2020-001512
Sahraei, F., Rahemi, Z., Sadat, Z., Zamani, B., Ajorpaz, N. M., Afshar, M., & Mianehsaz, E. (2022). The effect of Swedish massage on pain in rheumatoid arthritis patients: A randomized controlled trial. Complementary Therapies in Clinical Practice, 46. https://doi.org/10.1016/j.ctcp.2021.101524
Santosa, I. M. E., Jaariah, A., & Arsani, M. (2019). Pengaruh Terapi Kompres Hangat dengan Jahe Terhadap Perubahan Intensitas Nyeri pada Lansia yang Menderita Arthritis Reumatoid di Panti Sosial Tresna Werdha Puspakarma Mataram. Jurnal Prima, 2(1).
Sari, D. J. E., & Masruroh, M. (2021). Pengaruh Kompres Hangat Jahe Terhadap Intensitas Nyeri Rheumatoid Arthritis Pada Lansia. Indonesian Journal of Professional Nursing, 2(1), 33. https://doi.org/10.30587/ijpn.v2i1.2793
Satria, R. P. (2023). Pengaruh Senam Reumatik Terhadap Penurunan Nyeri Sendi Pada Lansia Dengan Rheumatoid Arthritis Di Wilayah Kerja Puskesmas Dukuhwaru Kabupaten Tegal. Jurnal Profesi Keperawatan, 10(1).
Setiawan, H., Firmansyah, A., & Anisa Firdaus, F. (2021). Studi Kasus Penggunaan Hot Ginger Compress Untuk Menurunkan Skala Nyeri Pada Pasien Arthritis Rheumatoid. Bina Generasi : Jurnal Kesehatan, 12(2). https://doi.org/10.35907/bgjk.v12i2.176
SevgiÜnal Aslan, K., & Çetinkaya, F. (2023). The effects of Reiki and hand massage on pain and fatigue in patients with rheumatoid arthritis. Explore, 19(2), 251–255. https://doi.org/10.1016/j.explore.2022.06.006
Shalahuddin, I., Pebrianti, S., Eriyani, T., Paltini, H., & Nurrahmawati, De. (2023). Efektivitas Aktivitas Fisik Terhadap Penurunan Nyeri Pada Lansia Dengan Rheumatoid Arthritis. Jurnal Ilmiah STIKES Kendal , 13(3), 1–14.
Slagter, L., Demyttenaere, K., Verschueren, P., & De Cock, D. (2022). The Effect of Meditation, Mindfulness, and Yoga in Patients with Rheumatoid Arthritis. In Journal of Personalized Medicine (Vol. 12, Issue 11). https://doi.org/10.3390/jpm12111905
Supiawati, E., & Purnama, A. (n.d.). Efektifitas Kombinasi Kompres Jahe dan Senam Rematik untuk mengurangi Intensitas Nyeri pada Rheumatoid Arthritis.
Sweeney, A. M. T., McCabe, C., Flurey, C. A., Robson, J. C., Berry, A., Richards, P., & Ndosi, M. (2021). The patient perspective of nurse-led care in early rheumatoid arthritis: A systematic review of qualitative studies with thematic analysis. Journal of Clinical Nursing, 30(1–2). https://doi.org/10.1111/jocn.15531
Taylor, P. C., Van De Laar, M., Laster, A., Fakhouri, W., Quebe, A., De La Torre, I., & Jain, S. (2021). Call for action: Incorporating wellness practices into a holistic management plan for rheumatoid arthritis - Going beyond treat to target. In RMD Open (Vol. 7, Issue 3). https://doi.org/10.1136/rmdopen-2021-001959
Tripathy, A., Swain, N., & Gupta, B. (2021). Understanding the Role and Uses of Alternative Therapies for the Management of Rheumatoid Arthritis. Current Rheumatology Reviews, 18(2).
https://doi.org/10.2174/1573397117666211116102454
Turk, M. A., Liu, Y., & Pope, J. E. (2023). Non-pharmacological interventions in the treatment of rheumatoid arthritis: A systematic review and meta-analysis. In Autoimmunity Reviews (Vol. 22, Issue 6).
https://doi.org/10.1016/j.autrev.2023.103323
Ulkhasanah, M. E., Sani, F. N., Titisari, R. A., & Safitri, N. A. (2023). Swedia Massage Sebagaian Upaya Menurunkan Nyeri Pada Lansia Dengan Rheumtoid Arthritis. Prosiding Seminar Informasi Kesehatan Nasional (SIKesNas).
Utli, H., & Yağmur, Y. (2022). The effects of Reiki and back massage on women’s pain and vital signs post-abdominal hysterectomy: A randomized controlled trial: The Effects of Reiki and Back Massage on Women’s Pain and Vital Signs. Explore, 18(4). https://doi.org/10.1016/j.explore.2021.07.004
Varkaneh, Z. K., Karampourian, A., Oshvandi, K., Basiri, Z., & Mohammadi, Y. (2022). The effect of eucalyptus inhalation on pain and the quality of life in rheumatoid arthritis. Contemporary Clinical Trials Communications, 29. https://doi.org/10.1016/j.conctc.2022.100976
Vitani, R. A. I. (2019). Tinjauan Literatur: Alat Ukur Nyeri Untuk Pasien Dewasa Literature Review: Pain Assessment Tool To Adults Patients. Jurnal Manajemen Asuhan Keperawatan, 3(1). https://doi.org/10.33655/mak.v3i1.51
Wu, D., Luo, Y., Li, T., Zhao, X., Lv, T., Fang, G., Ou, P., Li, H., Luo, X., Huang, A., & Pang, Y. (2022). Systemic complications of rheumatoid arthritis: Focus on pathogenesis and treatment. In Frontiers in Immunology (Vol. 13). https://doi.org/10.3389/fimmu.2022.1051082
Yanna Sihombing, Y. R., Marbun, R. A. T., Zebua, K. C., & Lestari, D. (2022). Evaluasi Penggunaan Obat Antiinflamasipada Pasien Rheumatoid Artritis Rawat Jalan Di Rumah Sakit Grandmed Lubuk Pakam.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Tsaniya Nurazizah, Ghina Nurjihan Naurah, Shopia Oktaviani, Nur Hidayat, Henri Setiawan, Jajuk Kusumawaty, Suhanda

This work is licensed under a Creative Commons Attribution 4.0 International License.













